Ethical health security in the age of antimicrobial resistance

ObjectiveOwing to its potential human, social and economic costs, antimicrobial resistance (AMR) is frequently referred to as a threat to health security. Simultaneously, health security and the preservation of antimicrobials are often described as a global public good. However, how the term ‘public good’ is used in the context of health security, and the values that underpin it, remains ambiguous. Policymaking is never value-free, and a better examination of such values is critical to understanding how issues such as AMR are problematised and how policy decisions are informed.DesignWe used McDougall’s version of critical interpretive synthesis to capture the recurring concepts and arguments within public policy, political science and applied ethics literature on AMR. Articles were analysed by identifying recurring ideas and developing themes across the literature.ResultsA total of 77 papers were included in our review. In the context of health security and AMR, the concept of ‘public good’ appears to be used interchangeably with ‘common good’, reflecting confusion, but sometimes meaningful differences, regarding how antimicrobials, as a good, are conceived. Main approaches to addressing AMR are statism, globalism and regionalism, which appeal to different values in guiding policymakers. Common justificatory values underpinning preservation of antimicrobials as a public good were prevention of harm, solidarity, justice and rights.ConclusionThe findings suggest that within the literature there is a lack of conceptual clarity as to whether antimicrobials constitute a public good or a common good. Moreover, the way in which antimicrobials are conceived and the approaches through which AMR as a threat to health security is addressed appear to be grounded in values that are often implicit. Being explicit about the values that underpin AMR and health security is not simply an intellectual exercise but has very real policy and programmatic implications.

The Problem of Consent in Feminist Practical Ethics

The article analyzes the topical problem of consent in modern feminist theory as a way of achieving public consensus on the goals and forms of women?s emancipation. The emancipation of women is one of the most important achievements of modern society and an ongoing process. Therefore, the issues that are being discussed within the framework of feminist ethics are appropriate. For example, the extent to which men who hold power and dominance for thousands of years can genuinely liberate women and share with them equal rights and opportunities. There is also an acute problem of the extent to which women them- selves are willing to show solidarity and their consent on social and political issues. These issues and dis- cussions by contemporary feminists, who deserve the attention of a wide range of experts in applied ethics, argumentation theory, social and political theory, are addressed in this study.

Business Ethics

Chapter 12, the last applied ethics chapter, considers some controversies in business. How should a firm’s owners, and related agents such as managers or state bank directors, engage with others, particularly workers and consumers? The chapter argues that the communal ethic does a better job of accounting for intuitions about who counts as a stakeholder and how to prioritize amongst competing stakeholder interests than does utilitarianism or Kantianism. Roughly, rightness as friendliness entails that not all duties of beneficence are a function of need or voluntary assumption of obligation to aid; a firm can also have pro tanto moral reason to help parties because it has related on friendly terms with them in the past. The chapter also takes up the question of how the production process ought to be structured, arguing that while the Western moral theories could well allow an unconstrained managerialism, the communal ethic probably does not.

Fostering hope and resilience amidst intractable ethical dilemmas brought about by the COVID-19 pandemic

This special issue of Etikk i Praksis – Nordic Journal of Applied Ethics features four articles that address a number of urgent ethical issues that arise in the COVID-19 pandemic.

Dialogue-Based Learning: A Framework for Inclusive Science Education and Applied Ethics

Dialogue-based learning is an inclusive pedagogy that leverages epistemological pluralism in the classroom to enhance cross-cultural education, encourage critical thinking across modes of inquiry, and promote novel contributions in applied ethics. The framework emerged from the Buddhism-science dialogue and our experiences teaching science courses for Tibetan Buddhists in India through the Emory-Tibet Science Initiative. Buddhism and science are two modes of inquiry that emphasize critical inquiry and empiricism, yet navigating complementarities and points of friction is challenging. Our proposed framework aims to raise awareness of onto-epistemological assumptions to convert them from obstacles into assets in dialogue. In drawing attention to epistemological orientations, our framework demonstrates that receptivity to other ways of knowing fosters clarity in one’s own views while creating space for new and enriching perspectives. In this article, we contextualize the Buddhism-science dialogue, explore the development of our dialogue-based learning framework, and demonstrate its application to a novel exchange about the COVID-19 pandemic. Broader aims of the framework include increasing scientific literacy and advancing transdisciplinary research.

The Applied Ethics and Habits of Compassionate Reasoning

Questions are more important than answers, since they open the mind and strengthen the imagination. The mind imagines the lives of others, the lives of strangers, and better societies. Compassionate Reasoning focuses on eliciting open questions, relationship building, active listening, and moral debate. Neuroscience demonstrates the essential role of repetition in the cultivation of prosocial neural pathways and habits. Modern education has failed thus far to invest in habits that generate reasoning in the service of compassion. Training in science and technology is only as useful as the compassionate lifestyle that it sustains. Without lifelong compassion education and training, STEM can create monstrous economics and dangerous technology. Compassionate societies are sustainable, whereas selfish societies often self-destruct. The more you give with compassion, the healthier you become. Compassionate Reasoning is a liberation from a selfish worldview, and it opens up the person to a flourishing life of service, health, and wisdom.

On the Road Without a Map: Why We Need an “Ethic of Road Ecology”

Over the past two decades, our knowledge of the ecological impacts of roads has increased rapidly. It is now clear that the environmental effects of transportation infrastructure are inextricable from transportation benefits to economic, social, and cultural values. Despite the necessity of optimizing these multiple values, road planners, scientists, and practitioners have no established methodology or pluralistic approach to address growing ethical complexities. We articulate five ethical issues that could be addressed by developing an ethic of road ecology in order to facilitate the identification, reasoning, and harmonization of ethical dimensions of road planning and development. This inquiry into road ecology can draw lessons from existing applied ethics, such as in ecological restoration and urban planning, to build a narrative that is informed by both science and ethics. We illustrate five ethical issues presented through case studies that elaborate on the motivations, responsibilities, and duties that should be considered in ethically and scientifically complicated road building decisions. To address these issues, we encourage the development of a code of ethics, dedicated intellectual forums, and practical guidance to assist road planners, and more broadly transportation practitioners, to resolve complex ethical quandaries systematically. We hope this perspective encourages conversation for a holistic yet pragmatic approach to this applied ethics problem, while also assisting responsible parties as they navigate difficult moral terrain.